Boning Up

Like the frame of a piece of sculpture, your bones form the skeletal support that enables us to sit, stand, and move. If your bones are not healthy, not strong enough to carry your weight, your body begins to fold like soft clay.

That weakening is called osteoporosis, a disease that can progress painlessly — until a bone breaks. Fractures in the hip, wrist, or spine are most common, and they are increasing as Baby Boomers age. At the start of this century, the U.S. population was experiencing 280,000 hip fractures annually, says Dr. Christopher Meckel, an orthopedic surgeon in Monterey. By 2040, that number is expected to increase to 500,000 fractures, due primarily to weak bones.

Healthcare costs related to such fractures have skyrocketed to $17 billion a year, elevating osteoporosis to epidemic proportions, Meckel says.

Age, family history, and other factors out of our control contribute to the loss of mineral density in our bones, but so do lifestyle choices.

“Bone, a storehouse for calcium, is thought of as an unchanging entity,” Meckel says. “But actually, it is extremely dynamic, always in a process of building up or tearing down. Bone mineral density is mainly a topic of concern among middle-aged and elderly women, but it actually spans all generations and affects men, too.

“Our ability to build up calcium ends around age 20. Around 50, we begin the downward spiral. So we should be teaching our children the importance of healthy bones and, to that end, of getting enough calcium.”

The primary recommendations for slowing or stopping osteoporosis involve exercise and diet. Weight-bearing exercises are recommended. These are activities done while on your feet that work the muscles and bones against gravity. Think walking, aerobics, or tennis, for example. In addition, people should have a healthy diet with calcium and vitamin D, which enables better absorption of calcium.

Dr. Christopher Meckel. orthopedic surgeon

“One way to get vitamin D, the ‘sunshine vitamin,’ is to get up to 15 minutes of sun exposure to the hands or arms three times a week,” Meckel says. “Yet as we get older, our skin gets thinner and the fatty layer diminishes, which means we can’t produce vitamin D as well. Also, because the sun’s rays can be harmful to the skin, we tend to use sun block, which reduces vitamin D production by 99 percent. That is why a lot of people turn to nutrition and diet supplements for vitamin D.”

To assess bone health, doctors use a bone-mineral-density test. This noninvasive scan can detect low bone density before a person breaks a bone; determine whether bone density is increasing, decreasing, or staying the same; and diagnose osteoporosis.

Women should begin osteoporosis screening no later than age 65, men by age 70. If you have risk factors for osteoporosis such as a history of fractures, smoking, or chronic steroid use, talk to your doctor about whether you should start screening earlier. The need for subsequent screenings will be determined by your doctor.

“Whether it is a 40-year-old woman with a wrist fracture or an elderly man whose spine can’t support him, we need to do a better job of managing this progressive disease,” Meckel says. “We can begin by screening to find out who has it and to what degree. Because 25 percent of people with osteoporosis are men, the screening is an important tool for women and men.”

Bone-density screenings for men and women are available at Community Hospital’s Breast Care Center. Talk to your doctor about whether you need one and for a referral.